早产儿解脲脲原体感染与支气管肺发育不良的相关性分析

Correlation analysis of preterm infection of ureaplasma urealyticum with bronchopulmonary dysplasia

目的探讨解脲脲原体（UU）感染与早产儿支气管肺发育不良（BPD）的相关性,旨在为降低早产儿感染率提供临床依据。方法选择2012年8月～2014年7月浙江省义乌市妇幼保健院收治的胎龄〈35周的早产儿148例作为研究对象。收集脐带血并采用荧光定量PCR技术和放射免疫技术测定早产儿的UU感染情况,并根据结果分为UU阳性组和UU阴性组,统计分析两组早产儿及产妇的基本临床特点,比较两组早产儿血培养、白细胞（WBC）、白细胞介素-8（IL-8）等相关血液指标及BPD发生率差异,分析UU和早产儿BPD的关系及其相关危险因素。结果 148例早产儿中,UU阳性29例（19.59%）,UU阴性119例（80.41%）;其中,UU阳性组的阴道分娩率及胎膜早破、绒毛膜羊膜炎发生率分别为86.21%、68.97%、10.34%,均显著高于UU阴性组（63.03%、36.13%、1.68%）,两组间比较差异均有统计学意义（均P〈0.05）,UU阳性组产儿的体重[（1073.29±451.51）g],显著低于UU阴性组[（1725.15±518.18）g],差异有统计学意义（P〈0.05）。UU阳性组的IL-8水平[（11.96±2.85）μg/L]明显低于UU阴性组[（18.78±2.61）μg/L],差异有统计学意义（P〈0.05）,而两组血培养、WBC比较,差异无统计学意义（P〉0.05）;另外,UU阳性组早产儿发生BPD者高达7例（24.14%）,显著高于UU阴性组的5例（4.20%）。Logistic回归分析也显示,BPD的危险因素主要有阴道分娩、胎膜早破、绒毛膜羊膜炎和IL-8（OR=1.817、3.287、2.653、4.087,均P〈0.05）。结论 UU感染与BPD密切相关,是早产儿BPD产生的重要原因之一,临床可根据产儿的感染情况及相关危险因素给予适当的干预措施,以有效降低产儿的感染率。

Objective To explore the correlation of preterm infection of ureaplasma urealyticum with bronchopulmonary dysplasia for the purpose of reducing the infection rate of preterm infants to provide clinical basis. Methods 148 cases of premature whose gestational age 〈35 weeks from August 2013 to July 2014 in Maternal and Child Health Hospital of Yiwu City were selected as the research subjects. The umbilical cord blood was collected and used the fluorescence quantitative PCR technique and radioimmunoassay to determinate the infection of ureaplasma urealyticum（UU）. According to the result, they were divided into the UU positive group and the UU negative group. The basic and clinical characteristics of two groups of preterm infant and maternal were statistical analyzed; the blood related indexes such as blood culture, WBC, IL-8 and the incidence of BPD in the preterm infants of the two groups were compared; the relationship between UU and BPD in premature infants and its relative risk factors were analyzed. Results In 148 cases of preterm infants, 29 cases patients were UU positive（19.59%）, 119 cases patients were UU negative（80.41%）. Among them, the constitute of vaginal delivery, fetal membranes early broken and chorioamnionitis of UU positive group were86.21%, 68.97%, 10.34% respectively, which were higher than those in the UU negative group（63.03%, 36.13%,1.68%）, the differences were statistically significant（all P 〈0.05）, but the baby weight [（1073.29±451.51） g] was significantly lower than that in the UU negative group [（1725.15±518.18） g], the difference was statistically significant（P 〈0.05）. The IL-8 level of the UU positive group [（11.96±2.85） μg/L] was significantly lower than that in the UU negative group [（18.78±2.61） μg/L], the difference was statistically significant（P 〈0.05）; while the blood culture, WBC of twogroups had no statistically significant difference（P 〉0.05）. In addition, the BPD of preterm infants in the UUpositive group was up to 7 cases（24.14%）, significantly higher than that 5 cases（4.20%） in the UU negative group. Logistic regression analysis also showed that the vaginal delivery, premature rupture of membranes, chorioamnionitis and IL-8 were mainly risk factors of BPD（OR =1.817, 3.287, 2.653, 4.087, all P 〈0.05）. Conclusion Ureaplasma urealyticum infection is closely related with bronchopulmonary dysplasia, which is one of the important causes of premature BPD production. According to the situation of perinatal infection and relate risk factors, clinic can give appropriate intervention measures to reduce the rate of perinatal infection.